Young people’s political identification isn’t about what’s trendy. You just left Marxism off your survey.

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Measured by self-identification, partisanship is actually declining — growing numbers of Americans describe themselves as “independent” rather than loyal to one of the parties. But measured by actual voting behavior, the opposite is happening: Straight ticket voting continues to grow. This matches what operatives like Dan Pfeiffer have seen, and what Karl Rove saw a decade before — the swing voter had nearly vanished.

One common explanation is that it has become increasingly vogue, especially among college-educated voters, to describe yourself as independent, which implies that you form educated judgments about politics rather than blindly following the dictates of a party. [emphasis added]

I have a much, much better explanation than this guy. Many Americans fucking hate both parties, but they think one will destroy the world and everything in it while the other will just make everything stay generally miserable or not get that much worse. So of course they don’t identify with a party, but they’ll vote for the one that isn’t going to burn everything down tomorrow. Those independents might be libertarians or socialists or anarchists or a thousand other political persuasions. I’d bet that an awful lot of them believe that no one who actually represents them or their ideals gets anywhere near the ballot.

Things all my real life friends find deathly boring

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Let’s talk about pill splitting. Sometimes you don’t want to take your full dose for some reason, or sometimes it’s cheaper to buy a higher dose than you really need and then split the pills. At some point, half blind from a migraine at 2am searching for the half that shot off the counter when you were cutting a pill with a knife, you thought there had to some better way to do this. And lo! On your next trip to the pharmacy, the pill splitter section is pointed out to you.

My very first pill splitter

This was way better than a knife. First of all, there was no danger of chopping my fingertips off. Secondly, it catches the pill in a little compartment. Unfortunately, it’s not that great at cutting pills exactly in half, especially convex round ones. Sometimes I get a 30/70 split or a 40/60 split. Sometimes it just sort of smushes the pill.

Some medications have a fair amount of wiggle room in the dose. Others put you to sleep for 4 hours when you get it just a little wrong. I went back to the knife and chasing pills across the floor.

That is the best pill splitter my pharmacy offers*, so I have been doing some online research. Perhaps this one, which comes with “12 different inserts so it can safely & easily cut pills & tablets of almost any shape” and would also complete my doll house washroom?

Possible new pill splitter type

Possible new pill splitter type

So, fellow people who see their pharmacist more than their boss, what are your tips and tricks for pill splitting? Do you need different pill splitters for different pills? Do you have a favorite splitter?

* In case you are thinking of buying this ubiquitous model: After surprisingly little use (~50 splits), some plastic bits have fallen off and the blue pill guides are uneven. It didn’t do perfectly even splits before, but now it’s really bad. I did not do violent things to this pill splitter.

While you’re waiting for the bus

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Stuff worth reading

Making the Rich and Powerful Work for Everyone

Comment on Guest Post: Changing my surname was a personal choice by jmc38

The Anthropocene Myth. Blaming all of humanity for climate change lets capitalism off the hook

TPP leak: states give companies the right to repeal nations’ laws.
Nothing I’ve read about the TPP makes me think it is a remotely good idea

Startup workers sue to be recognized as employees, not mere contractors

Facing Early Death, on Their Terms

Minimal landscape maps
Click through for the corn.

Dropping Light
Also we would look like demons

Unifying ecology and macroevolution with individual-based theory

Hoax-detecting software spots fake papers
“It’s wonderful that Springer has moved to eliminate articles generated by software that intentionally produces nonsense, but what about unintentionally nonsensical articles produced by human authors?”

Max Planck Society unveils €50 million support plan for young scientists
Excellent

Where did all my money go?

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Several times a year, I look at my overall income and then my savings account and feel like a terrible, wasteful, spendy person. I think, given how much I’m making, I should have been able to save $X. And then I remember to factor in tuition and how much it went up again, and I’ve actually managed to do ok.

Also, I would like to point out that I am in a very, very unusual situation. Most grad students do not have the kind of funding where they can pay tuition and save money. I also expect to be living on my savings for a year at the end of my PhD.

Working through a heart attack

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The other morning I started feeling weird and not very good. I ignored it for several hours, but I kept feeling worse. I very recently started taking a new supplement for my migraines, and I realized that I hadn’t done very thorough research on its interactions with the other drugs I take. Maybe I shouldn’t actually take it… Thanks to socialized medicine, I can talk to a registered nurse or pharmacist whenever I want. My question, “could my supplement be causing my symptoms?” was ignored. Instead, they sent an ambulance.

I did not think there was an emergency. I could move around quite easily. I was a bit distracted by not feeling well, but by and large, I could do all my normal activities. I assumed I’d be sending the EMTs on their way likety-split. Instead, within a few moments of beginning the physical exam, they’d whisked me into the ambulance.

Bloodwork, tests, and thorough interviews followed in short order at the hospital. I left with paperwork for specialists with URGENT stamps all over it once they’d assured themselves that I wasn’t going to keel over on them right then.

This experience was illuminating for a few reasons. First, how migraine is treated in the ER and second, how different kinds of illness impact me.

Compared to times I’ve been to the ER with a migraine, there was basically no waiting once we arrived. Clearly, triaging makes sense – a potential heart attack patient always outweighs someone who has a migraine because the migraine patient is so much less likely to die right there in front of you. But sitting in a bright, loud waiting room for 6 hours with a very bad migraine after being in terrible pain for days on end? It’s nightmarish. ER doctors often ask why I waited so long to come in. Apart from the fact that the drugs themselves are quite unpleasant and carry serious risks, the barrier of the waiting room is often what keeps me away until things are truly dire.

I had a sky high heart rate and arrthymia and many very uncomfortable symptoms typically associated with heart failure. I was also well enough to work almost all day (as long as working didn’t involve walking very far…). The times I was sickest? After I had my blood drawn. (The ER phlebotamists were amazing, but I am a pansy.) I often feel very frustrated with myself for not working during mild migraines. The pain isn’t that bad! If I can watch Netflix, why can’t I watch a lecture? If I can read a novel, why can’t I read a paper? This experience reminded me that migraine is a special beast. First of all, the pain is that bad. Secondly, migraines are not just pain. It’s just not realistic to expect myself to be able to do complex intellectual work during a migraine on a regular basis.

Migraining with money

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A few weeks ago, I forgot some of my meds on an overnight trip. Yikes! Luckily, the pharmacy I use has a store just a few blocks from where I was staying, so I had my prescription moved over. I figured I’d just get my refill early.

This turned out to be a bad idea.

My insurance company had recently changed their policy about how soon prescriptions could be refilled, and I hadn’t used enough of my last refill to get covered for a new one yet. So instead of being $0.05/pill, it was $4.00/pill. Fortunately the pharmacist warned me. This meant I only got the pills I absolutely needed for the next few days and then moved my prescription back to my home pharmacy.

That’s $4.00/pill for the generic version of a drug that people typically take 4 to 8 of daily. Let me do the math for you – if I didn’t have insurance, I’d have to shell out $480 every month.

Many of the triptans are now generic, too. That’s definitely brought down the cost, but $12 – 46 per pill is not what I’d call cheap.

Which brings me to the point of this post. Migraine affects people all over the world, places where $4 is a lot of money. So what are people supposed to do there?

Linde et al. recommend amitriptyline for people who need preventatives and aspirin for acute treatment in low and middle income countries. I am so glad those are not my only options.

Amitriptyline sucks. I slept almost all the time when I took it, and when I wasn’t asleep, I wished I was. In my migraine log, it looks like my migraines are better when I was on amitriptyline. I have no idea if they were or not. I do know that I was too exhausted to record migraines when I got them.

I personally wonder why they don’t recommend melatonin. It has a way better side effect profile and seems to work as well or better than amitriptyline for episodic migraine. I think it’s pretty cheap, too. Maybe there just isn’t as much research backing its use up as for amitriptylene.

As for their acute recommendation, I do not know anyone who takes aspirin for migraines. I found some studies that suggest it works ok, but I find it useless.

Linde et al. point out a serious problem – migraine patients without a lot of money do not have good options. Implementing their recommendations, as much as I’ve criticized them, would likely improve a lot of people’s lives. But things would still be very bad for migraine patients. Are there any migraine patients reading this who find their migraines are best controlled with amitriptylene and aspirin?

We should have better, cheaper access to all drugs worldwide. We can’t keep doing these special programs for the disease du jour. First of all, they don’t work very well. Secondly, there are a lot of diseases that will be ignored, like migraine, because they don’t have high mortality rates. I’m pleased to see India is standing up to the US on the issue of generics in the TPP. I think if they hold firm, they could make a big difference as their generic pharma industry continues to grow, as long as they get their regulatory issues sorted.